Attorneys general from 29 US states urge tougher e-cigarette regulations

BMJ 2014; 349 doi: (Published 13 August 2014) Cite this as: BMJ 2014;349:g5154
  1. Michael McCarthy
  1. 1Seattle

Attorneys general from 29 states have called on the US Food and Drug Administration to impose tougher regulations on electronic cigarettes (e-cigarettes).

These E-cigarettes are battery powered devices that generate a vapor containing nicotine and have become increasingly popular among smokers and nonsmokers seeking the psychoactive effects of nicotine without smoking traditional cigarettes.

Supporters of e-cigarettes argue that the devices provide a safer alternative to cigarettes and can help smokers wean themselves off traditional tobacco products. But opponents contend that they are “starter” products, which can be used to addict young people to nicotine and induce them to take up smoking cigarettes and other tobacco products.

In April, the FDA proposed new regulations governing the marketing and sales of e-cigarettes that many opponents of tobacco said did not go far enough.1 Those rules, if implemented, would forbid sales of e-cigarettes to anyone under 18, require health warnings on the products, and ban any claims of health benefits that were not approved by the FDA. But the rules would not ban radio or television advertising or internet sales or the use of flavorings, which critics say the manufacturers use to attract young nonsmokers.

In a letter to the FDA, the attorneys general called on the agency to impose tougher regulations, including: a ban on any flavorings other than tobacco and menthol; prohibiting television, radio, and internet advertising; and a ban on youth targeted marketing such as the use of celebrity endorsements, cartoons, and social media campaigns. The FDA already enforces such rules for traditional cigarettes and smokeless tobacco products.

The letter also urged the FDA to demand tougher health warnings on e-cigarettes. “The warning proposed by the FDA—that e-cigarettes contain nicotine, which is addictive—will not prevent consumers from starting nicotine use or encourage them to quit,” the letter said. “The content of effective warnings on e-cigarettes should be varied, explicit, vivid, and emotionally persuasive.”

It added, “We don’t need these e-cigarettes aimed at our youth. What we need are strong FDA regulations that protect the public health and protect our youth from a lifetime of nicotine addiction. The FDA should ban all flavored electronic cigarettes and should prohibit e-cigarette advertising on television, radio, and youth oriented magazines.”

The FDA is due to issue the final regulations in June 2015.


Cite this as: BMJ 2014;349:g5154


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